COMPARISON BETWEEN THE INCIDENCE OF SEXUAL DYSFUNCTIONS ASSOCIATED WITH TWO ANTIDEPRESSANTS USED IN A TERTIARY LEVEL HOSPITAL: SERTRALINE VERSUS MIRTAZAPINE
Antidepressants especially SSRIs like Sertraline have been associated with higher incidence of antidepressant induced sexual dysfunction in patients under treatment. Several reports have suggested Mirtazapine with its unique inhibitory action on adrenergic and serotonergic receptors might have lesser propensity to cause sexual dysfunction. However there are studies which show that incidence of sexual dysfunction after use of Mirtazapine may be higher than previously expected.
The aim of the study was to assess and compare the incidence of sexual dysfunction after therapy with Sertraline and Mirtazapine in a Nepali population.
Patients needing antidepressant therapy but with minimal or no sexual dysfunction at baseline were randomly assigned to either Mirtazapine (n=54, 7.5-30 mg) or Sertraline (n=54, 25-100 mg). Sexual functioning at baseline was measured with Change in Sexual Functioning Questionnaire (CSFQ) and the same was reassessed at 4 weeks.
The incidence of sexual dysfunction seen in 42.9% patients in Sertraline group and 23.7% patients in MIrtazapine group. there was no statistical significance in this finding. There was significant difference in the Desire\frequency aspect of sexual functioning between the two difference (p=0.041) where Mirtazapine had greater influence on the score than Sertraline. There was significant difference in the Orgasm aspect of sexual functioning where Sertraline showed greater decline in functioning than Mirtazapine. (p=0.009).
Although lesser in propensity, Mirtazapine is not free of adverse effect of sexual dysfunction. Sertraline caused significant decline in Orgasm aspect of sexual functioning. More studies are need to further confirm these findings.
Author's Name: Dr. Gaurav Bhattarai